1. Steroidal Versus Non-steroidal
The two primary categories of anti-inflammatory drugs include steroidal and non-steroidal anti-inflammatory drugs (NSAID). Steroidal anti-inflammatory medications, often referred to as corticosteroids, include cortisone, prednisone and methylprednisolone. Patients receive corticosteroids orally, through an injection into a vein, muscle or joint or through a cream rubbed onto the body. The most common NSAIDs include aspirin, acetaminophen, diclofenac, indomethacin, ketorolac, ibuprofen, and naproxen.
2. The Prostaglandin Connection
NSAIDs function by impeding the efficacy of the enzyme cyclooxygenase (Cox), which is integral in the production of prostaglandins. Your prostaglandins cause inflammation, aching and fever. By inhibiting prostaglandin production, you reduce inflammation, fever and pain. Unfortunately, the Cox-1 enzymes also protect the lining of your stomach. Consequently, if you take a NSAID medication to reduce inflammation, you may also suffer some stomach upset. The good news is that some new generation NSAID medications cause less stomach upset, because they don't target the Cox-1 enzyme quite as much as previous medications.
3. How the Corticosteroid Works
Synthetic corticosteroids, or glucocorticoids, are similar to cortisol, a natural hormone produced by your body. Researchers and doctors still haven't isolated exactly how corticosteroids reduce inflammation; however, they do believe that corticosteroids suppress the production of various substances that cause inflammation, such as prostaglandin. In addition, corticosteroids reduce the efficacy of white blood cells, which subsequently reduces your ability to fight disease.
4. Watch Out for Corticosteroid Side Effects
When you take corticosteroids to reduce inflammation, watch out for side effects. Typical side effects include fluctuations in appetite, nervousness, restlessness, mood swings, water retention, weight gain, blurred vision, acne, changes in sleep patterns and indigestion. As your body adjusts to corticosteroids, these symptoms may abate. While serious side effects aren't common, they can occur. If you experience wheezing, a tight chest or difficulty breathing, contact a doctor immediately. When taken over a prolonged period, corticosteroids reduce your body's ability to ward off infection. They also make it more difficult to treat existing infections.
5. Consider the More Serious NSAID Side Effects
NSAIDs can wreak havoc on your stomach and gastrointestinal system. Some of the side effects include abdominal pain, diarrhea, and upset stomach. When a patient takes NSAIDs over a long period, there's increased risk for developing ulcers of the stomach and duodenum. Sometimes these ulcers go undetected, leading to more severe complications, such as bleeding and perforation of the stomach. While the risks are cause for concern, they don't affect the majority of people taking NSAIDs. If you're elderly, have rheumatoid arthritis or have a history of heart disease or ulcers, then you may be at greater risk. Also, certain medications, such as Coumadin, heparin and prednisone increase the risk of developing side effects.
